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European birth battle round two!

The European Court of Human Rights will consider women’s right to choose where to give birth in the case of Dubska and Krejzova v Czech Republic on 10 September. This will be the second time the Court has looked at the issue, following Ternovszky v Hungary (December 2010).

In Ternovszky, the Court held that birth choices were protected under the right to private life in Article 8 of the European Convention on Human Rights and the Hungarian state could not lawfully sanction midwives for attending women at home. Czech law does not explicitly criminalise midwives’ attendance at home births but medical regulations make it impossible in practice to provide midwifery services at home lawfully, public insurance does not cover the costs of home birth and midwives have been charged with criminal offences after poor outcomes at home. Neither of the two women applicants to the European Court were able to find a midwife who was permitted to assist them at home.

Czech maternity care has been criticised by the UN Committee on the Elimination of Discrimination Against Women:

“While acknowledging the need to ensure maximum safety for mothers and newborns during childbirth, as well as the State party’s low perinatal mortality rate, the Committee takes note of reports of interference with women’s reproductive health choices in hospitals, including the routine application of medical interventions, reportedly often without the woman’s free, prior and informed consent or any medical indication, a rapid increase in the caesarean section rate, separation of newborns from their mothers for up to several hours without health-related reasons, refusal to release the mother and child from hospital before 72 hours after childbirth, and patronizing attitudes of doctors which impede the exercise by mothers of their freedom of choice. It also notes reports about women’s limited options for delivering their babies outside hospitals.

The Committee recommends that the State party consider accelerating the adoption of a law on patients’ rights, including women’s reproductive rights; adopt a protocol of normal birth care ensuring respect for patients’ rights and avoiding unnecessary medical interventions; ensure that all interventions are performed only with the woman’s free, prior and informed consent; monitor the quality of care in maternity hospitals; provide mandatory training for all health professionals on patients’ rights and related ethical standards; continue raising patients’ awareness of their rights, including by disseminating information; and consider taking steps to make midwife-assisted childbirth outside hospitals a safe and affordable option for women.”

The Dubska case gives the European Court another opportunity to clarify European states’ responsibility for protecting and enabling women’s birth choices.

You can watch the hearing live-streamed in English on the Court website.